Labral Repair Bankart

Understanding
The Bankart
Procedure
William T. Pennington, M.D.
wpennington@theorthoinstitute.com
Our goal at The Orthopedic Institute of Wisconsin is to provide high quality
care, both non-surgical and surgical. This approach allows our patients to
regain lost function and experience pain relief that will hopefully result in the
improvement of their quality of life. If you have any additional questions,
please call: (414) 325-4320
Understanding Shoulder
Anatomy
The shoulder is a large ball
and socket joint composed of
bones, tendons, muscles, and
ligaments. The bones of the
shoulder joint include: your
collarbone, your upper arm
bone, and your shoulder
blade. The rounded head of
the humerus fits into a
shallow socket in the
shoulder blade, known as the glenoid. The glenoid is
surrounding by a rim of cartilage that deepens the socket, known as
the glenoid labrum, a static stabilizer of the shoulder joint.
What is a Bankart Lesion?
When the shoulder dislocates, the humeral head slips out of the
glenoid socket. Because of forceful movement out of the socket, the
labrum that acts as a bumper for the humeral head often tears.
Oftentimes, because of the force on the front of the labrum, the back
can also experience stress and tearing. Patients often present with a
sense of shoulder instability, repeat dislocations, and an aching
shoulder.
The Orthopedic Institute of Wisconsin
www.theorthoinstitute.com
(414) 325-4320
Causes of a Bankart Lesion
These labral tears are most
commonly due to trauma and
dislocation. Over 95% of all
shoulder dislocations result in
an accompanying bankart
lesion. The majority of
dislocations are due to the
humerus moving too far
forward or too far downward
from it original position in the
glenoid. Forceful external
rotation when the arm is raised
typically provides enough stress
to force the shoulder out of its
socket.
William T. Pennington, M.D.
wpennington@theorthoinstitute.com
The Surgery
This surgery, typically lasting between 30-45 minutes, repairs the
torn labrum so that the shoulder joint can regain stability. It is
performed arthroscopically, by inserting a small camera into the
shoulder through 2-3 small incisions. In some cases, a Bankart lesion
is debrided, meaning that the torn portion of the labrum is shaved
away to leave a smooth edge of healthy tissue. If the tear is
repairable, anchors are used to attach the labrum back to its original
position. Sutures are attached to these anchors, allowing the anchors
to hold the repair firmly in place once they are hammered into the
bone. Each suture is passed under the labrum and is tightened, securing
the labrum back to the glenoid. Once the repair is complete, the humeral
head should once again be secure in the shoulder socket.
Arthrex Inc. “Knotless Labral.”
http://www.arthrex.com/shoulder/knotless-labralinstability-alpsa-and-hagl-lesion-repair
Typical Schedule of
Follow-up Visits
Post-Operative Expectations
Five-to-seven day assessment
• Suture removal
• Check in with your Dr.
Pennington’s surgical
team
Five-to-seven week assessment
• Passive motion check
• Progress into the active
range of motion phase
Monthly assessments
• Range of motion check
• Strength check
• Discuss return to
activity/sport
A polar ice pack is placed on the shoulder to
help decrease inflammation and pain. Patients
are typically kept in a sling after surgery to serve
as a reminder to not move the arm above
shoulder level or behind their back. Gentle range
of motion below shoulder level and in front of
Arthrex Inc. “Knotless Suture
Anchors.”http://www.arthrex. your body is allowed. In the first four weeks
com/hand-wrist/knotlesssuture-anchorstechnique
following surgery the goal is to minimize pain and
protect the repair site. Many patients have difficulty finding a
comfortable sleeping position at first, and find that sleeping in a
recliner or propped up with pillows is more comfortable. You may
sleep in a bed anytime. You may drive once you are off your pain
medication. No strengthening exercises may be performed until 12
weeks following surgery. You may return to work within several
days unless your job requires heavy lifting, in which case, your
return may be delayed. Return to full athletic activities can be
expected in 3-4 months.
Physical Therapy
Dana Hahn, Brian
William
Patient Care Bartz, Pennington,
Coord.
PA-C
MD
Joann
Pitton,
PA-C
Following your surgery, you will be given a continuous passive
motion (CPM) machine to assist with early, passive motion.
Physical therapy is typically started three weeks after the procedure.
Therapy session should be attended two to three times per week.
After spending time with your physical therapist, you will learn how
to perform your exercise program on your own at home. When you
do not have supervised physical therapy, it is crucial that you
continue your physical therapy program at home. The best results
will come to those patients who perform their exercises until
completely healed.
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